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Ergonomic Guidelines : Policies and Procedures for Prevention of Work Related Musculoskeletal Disorders in Sonographers: Provide adequate work space Position monitor / keyboard Proper use of adjustable exam chairs / tables Vary postures throughout day / sit or stand Alternate the scanning hand / vary the grip used Minimize awkward / extreme postures Increase tissue tolerances through exercise and adequate rest Schedule different types of exams in a work day Limit the number of portable exams Consider a maximum number or exams per day Annual training and reassessment

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Characteristics of Results: 60% of injuries reported from female sonographers 60% of injuries reported from sonographers > 20 years in the field 100% of injuries reported from single hand scanners (scan with only left or only right hands) Decrease in incidence despite conversion to inpatient scanning at bedside (Echo = 100%, Vasc = 50%.)

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Study Limitations: Individual Sonographers not evaluated a)Compliance to Ergonomic recommendations not measured b)Limited Long term follow-up Cardiac and Vascular Ultrasound only Reviews only Reported Injuries Statistical Significance of Variability not evaluated.